Decisions on entitlement to sickness benefits and return to work interventions have substantial impact on individuals’ lives and on society. In most Western European countries, such decisions are based on sickness certificates, which should provide information on how a disease or injury reduces the individual’s work ability. These are challenging and complex assessments. In 2008, guidelines for the management of sick leave were implemented in Sweden, emphasizing early assessments of work ability and return to work, and increasing the quality demands of sickness certificates by underscoring descriptions of activity limitations related to work. The overall aim of this thesis was to gain a deeper knowledge of the sick leave process with special emphasis on the content of sickness certificates and primary health care (PHC) professionals’ experiences with the process. Specific aims were to compare the quality of sickness certificates regarding descriptions of functioning by the use of WHO’s International Classification of Functioning, disability, and health (ICF), as well as the prescribed interventions before versus after implementation of the Swedish sick leave guidelines.

The thesis comprises three studies. A cross-sectional design was used in studies I and II, which included 475 and 501 new sickness certificates consecutively collected in Östergötland County, Sweden, in 2007 and 2009, respectively. Text on functioning was analysed with a deductive content analysis using the ICF. Study III was an exploratory study using data from four semi-structured focus group discussions with a purposeful sample of PHC professionals (n=18) in Östergötland County. An inductive content analysis was used in this study.

The thesis comprises three studies. A cross-sectional design was used in studies I and II, which included 475 and 501 new sickness certificates consecutively collected in Östergötland County, Sweden, in 2007 and 2009, respectively. Text on functioning was analysed with a deductive content analysis using the ICF. Study III was an exploratory study using data from four semi-structured focus group discussions with a purposeful sample of PHC professionals (n=18) in Östergötland County. An inductive content analysis was used in this study.

An overall conclusion drawn from this thesis is that patient functioning and needs might not be adequately communicated in the sick leave process. Despite the implementation of sick leave guidelines, this information is limited in sickness certificates and the collaboration is poor among the involved stakeholders, i.e., health care, the social insurance office, the employer and the OHS. The basis for decisions on entitlement to sickness benefits could be improved by including a description of the patients’ activity limitations or participation restrictions related to work demands. One way to enhance the decision basis might be to use the available team competencies at the PHC.

Öberg, Birgitta

Abstract [en]

Aims: Sickness certificates are to provide information on a disease and its consequences on the patients functioning. This information has implications for the patients rights to sickness benefits and return-to-work measures. The objective of this study was to investigate the description of functioning in sickness certificates according to WHOs International Classification of Functioning, Disability, and Health (ICF), and to describe the influence of patients age, gender, diagnostic group, and affiliation of certifying physician.

Method: A content analysis of written statements regarding how the disease limits the patients functioning with ICF as a framework was performed in 475 sickness certificates, consecutively collected in Ostergotland County, Sweden.

Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). Certificates were mainly issued from physicians at hospitals and in primary health care (PHC). ICF was applicable for classifying statements regarding functioning in 311 certificates (65%). The distribution of components was 58% body functions, 26% activity, and 7% participation. The descriptions were primarily restricted to the use of at least one component; namely, body functions. Subgroup analysis showed that descriptions of activity and participation were more common in certificates for MD and MSD, or those issued by PHC physicians. A multiple regression analysis with the activity component as dependent variable confirmed the results by showing that activity was related to both diagnosis and affiliation.

Conclusions: In a consecutive sample of sickness certificates, it was shown that information on functioning is scarce. When functioning was described, it was mainly body oriented.

Öberg, Birgitta

Abstract [en]

Purpose: To investigate whether patients are prescribed rehabilitation early in a new sick leave period, and whether this prescription is associated with age, sex, diagnosis, description of functioning, and affiliation of certifying physician.

Methods: A cross-sectional study using data from sickness certificates issued during a total sick leave period, collected consecutively during 2 weeks in 2007 in Östergötland County, Sweden. Rehabilitation prescribed in the first certificate or within 28 days after the start of sick leave was defined as early rehabilitation.

Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). The mean certified duration of sick leave was 94 days (SD 139), longest for MD patients. Early rehabilitation was prescribed in 27% of all certificates and in 45% of certificates for MSD and MD diagnoses. Logistic regression analysis indicated that prescription of early rehabilitation was associated with certificates issued for MSD and MD, youngest patients, and certificates issued by primary health care physicians. The final model explained 29% of variation in the prescription of early rehabilitation.

Conclusion: There is a modest prescription of early rehabilitation in sickness certificates, based on younger age and MSD or MD diagnosis. This indicates that patients’ rehabilitation needs may not have been identified.

Öberg, Birgitta

Abstract [en]

Background: Long-term sickness absence is high in many Western countries. In Sweden and many other countries, decisions on entitlement to sickness benefits and return to work measures are based on information provided by physicians in sickness certificates. The quality demands, as stressed by the Swedish sick leave guidelines from 2008, included accurate sickness certificates with assessment of functioning clearly documented. This study aims to compare quality of sickness certificates between 2007 and 2009 in Ostergotland County, Sweden. Quality is defined in terms of descriptions of functioning with the use of activity and participation according to WHOs International Classification of Functioning, Disability and Health (ICF), and in prescriptions of early rehabilitation.

Methods: During two weeks in 2007 and four weeks in 2009, all certificates had been collected upon arrival to the social insurance office in Ostergotland County, Sweden. Four hundred seventy-five new certificates were included in 2007 and 501 in 2009. Prolongations of sick leave were included until the last date of sick listing. Free text on functioning was analysed deductively using the ICF framework, and placed into categories (body functions/structures, activity, participation, no description) for statistical analysis.

Results: The majority of the certificates were issued for musculoskeletal diseases or mental disorders. Text on functioning could be classified into the components of ICF in 65% and 78% of sickness certificates issued in 2007 and 2009, respectively. Descriptions according to body components such as "sensations of pain" or "emotional functions" were given in 58% of the certificates from 2007 and in 65% from 2009. The activity component, for example "walking" or "handling stress", was more frequent in certificates issued in 2009 compared with 2007 (33% versus 26%). Prescriptions of early rehabilitation increased from 27% in 2007 to 35% in 2009, primarily due to more counseling.

Conclusions: An improvement of the quality between certificates collected in 2007 and 2009 was demonstrated in Ostergotland County, Sweden. The certificates from 2009 provided more information linkable to ICF and incorporated an increased use of activity limitations when describing patients functioning. Still, activity limitations and prescriptions of early rehabilitation were only present in one-third of the sickness certificates.

Öberg, Birgitta

Abstract [en]

Purpose The aim of this study was to explore primary healthcare (PHC) professionals' experiences of the sick leave process. Methods This is an explorative study using data from four semi-structured focus group discussions with a purposeful sample of PHC professionals in A-stergotland County, Sweden. Content analysis with an inductive approach was used in the analysis. Results Four key themes emerged from the analysis; priority to the sick leave process, handling sickness certifications, collaboration within PHC and with other stakeholders, and work ability assessments. Patients' need for sick leave was handled from each professional group's perspective. Collaboration was considered important, but difficult to achieve and all the competencies available at the PHC centre were not used for work ability assessments. There was insufficient knowledge of patients' work demands and contact with an employer was rare, and the strained relationship with the social insurance officers affected the collaboration. Conclusions This study highlights the challenges physicians and other PHC professionals face when handling the need for sick leave, especially when encountering patients with symptom-based diagnoses, and the influence of non-medical factors. Hindrances to good practice were increased demands, collaboration, and role responsibility. The challenges in the sick leave process concerned both content and consequences related to poor collaboration within PHC and with representatives from various organizations, primarily employers and social insurance officers. Further research on how to develop a professional approach for handling the sick leave process is needed.

Purpose: To investigate whether patients are prescribed rehabilitation early in a new sick leave period, and whether this prescription is associated with age, sex, diagnosis, description of functioning, and affiliation of certifying physician.

Methods: A cross-sectional study using data from sickness certificates issued during a total sick leave period, collected consecutively during 2 weeks in 2007 in Östergötland County, Sweden. Rehabilitation prescribed in the first certificate or within 28 days after the start of sick leave was defined as early rehabilitation.

Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). The mean certified duration of sick leave was 94 days (SD 139), longest for MD patients. Early rehabilitation was prescribed in 27% of all certificates and in 45% of certificates for MSD and MD diagnoses. Logistic regression analysis indicated that prescription of early rehabilitation was associated with certificates issued for MSD and MD, youngest patients, and certificates issued by primary health care physicians. The final model explained 29% of variation in the prescription of early rehabilitation.

Conclusion: There is a modest prescription of early rehabilitation in sickness certificates, based on younger age and MSD or MD diagnosis. This indicates that patients’ rehabilitation needs may not have been identified.

Background: Long-term sickness absence is high in many Western countries. In Sweden and many other countries, decisions on entitlement to sickness benefits and return to work measures are based on information provided by physicians in sickness certificates. The quality demands, as stressed by the Swedish sick leave guidelines from 2008, included accurate sickness certificates with assessment of functioning clearly documented. This study aims to compare quality of sickness certificates between 2007 and 2009 in Ostergotland County, Sweden. Quality is defined in terms of descriptions of functioning with the use of activity and participation according to WHOs International Classification of Functioning, Disability and Health (ICF), and in prescriptions of early rehabilitation.

Methods: During two weeks in 2007 and four weeks in 2009, all certificates had been collected upon arrival to the social insurance office in Ostergotland County, Sweden. Four hundred seventy-five new certificates were included in 2007 and 501 in 2009. Prolongations of sick leave were included until the last date of sick listing. Free text on functioning was analysed deductively using the ICF framework, and placed into categories (body functions/structures, activity, participation, no description) for statistical analysis.

Results: The majority of the certificates were issued for musculoskeletal diseases or mental disorders. Text on functioning could be classified into the components of ICF in 65% and 78% of sickness certificates issued in 2007 and 2009, respectively. Descriptions according to body components such as "sensations of pain" or "emotional functions" were given in 58% of the certificates from 2007 and in 65% from 2009. The activity component, for example "walking" or "handling stress", was more frequent in certificates issued in 2009 compared with 2007 (33% versus 26%). Prescriptions of early rehabilitation increased from 27% in 2007 to 35% in 2009, primarily due to more counseling.

Conclusions: An improvement of the quality between certificates collected in 2007 and 2009 was demonstrated in Ostergotland County, Sweden. The certificates from 2009 provided more information linkable to ICF and incorporated an increased use of activity limitations when describing patients functioning. Still, activity limitations and prescriptions of early rehabilitation were only present in one-third of the sickness certificates.

Aims: Sickness certificates are to provide information on a disease and its consequences on the patients functioning. This information has implications for the patients rights to sickness benefits and return-to-work measures. The objective of this study was to investigate the description of functioning in sickness certificates according to WHOs International Classification of Functioning, Disability, and Health (ICF), and to describe the influence of patients age, gender, diagnostic group, and affiliation of certifying physician.

Method: A content analysis of written statements regarding how the disease limits the patients functioning with ICF as a framework was performed in 475 sickness certificates, consecutively collected in Ostergotland County, Sweden.

Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). Certificates were mainly issued from physicians at hospitals and in primary health care (PHC). ICF was applicable for classifying statements regarding functioning in 311 certificates (65%). The distribution of components was 58% body functions, 26% activity, and 7% participation. The descriptions were primarily restricted to the use of at least one component; namely, body functions. Subgroup analysis showed that descriptions of activity and participation were more common in certificates for MD and MSD, or those issued by PHC physicians. A multiple regression analysis with the activity component as dependent variable confirmed the results by showing that activity was related to both diagnosis and affiliation.

Conclusions: In a consecutive sample of sickness certificates, it was shown that information on functioning is scarce. When functioning was described, it was mainly body oriented.

Purpose The aim of this study was to explore primary healthcare (PHC) professionals' experiences of the sick leave process. Methods This is an explorative study using data from four semi-structured focus group discussions with a purposeful sample of PHC professionals in A-stergotland County, Sweden. Content analysis with an inductive approach was used in the analysis. Results Four key themes emerged from the analysis; priority to the sick leave process, handling sickness certifications, collaboration within PHC and with other stakeholders, and work ability assessments. Patients' need for sick leave was handled from each professional group's perspective. Collaboration was considered important, but difficult to achieve and all the competencies available at the PHC centre were not used for work ability assessments. There was insufficient knowledge of patients' work demands and contact with an employer was rare, and the strained relationship with the social insurance officers affected the collaboration. Conclusions This study highlights the challenges physicians and other PHC professionals face when handling the need for sick leave, especially when encountering patients with symptom-based diagnoses, and the influence of non-medical factors. Hindrances to good practice were increased demands, collaboration, and role responsibility. The challenges in the sick leave process concerned both content and consequences related to poor collaboration within PHC and with representatives from various organizations, primarily employers and social insurance officers. Further research on how to develop a professional approach for handling the sick leave process is needed.

Robots in human co-habited environments need human-aware task and motion planning, ideally responding to people’s motion intentions as soon as they can be inferred from human cues. Eye gaze can convey information about intentions beyond trajectory and head pose of a person. Hence, we propose eye-tracking glasses as safety equipment in industrial environments shared by humans and robots. This paper investigates the possibility of human-to-robot implicit intention transference solely from eye gaze data. We present experiments in which humans wearing eye-tracking glasses encountered a small forklift truck under various conditions. We evaluate how the observed eye gaze patterns of the participants related to their navigation decisions. Our analysis shows that people primarily gazed on that side of the robot they ultimately decided to pass by. We discuss implications of these results and relate to a control approach that uses human eye gaze for early obstacle avoidance.

This article looks at the characteristics of contemporary sports audiences from the perspective of gender, focusing on the phenomenon of female ultras or ‘professional’ football fans. Drawing on ethnographic research conducted in an Italian football ultrasgroup composed of male and female fans, this paper offers an analysis of female participation in communities of organized supporters. In examining the role and position of women inside the considered group, the paper pays attention to their perception of the existing gender differences showing how female ultras explain inequalities on the basis of ‘natural’ and ‘innate’ differences and capacities between men and women. Existing patterns of male dominance are supported by female fans’ own discourses and performance of their gender identity in the ‘male preserve’. Rather than questioning male dominance and gender hierarchies, female supporters’ efforts appear aimed at being recognized as ultras ‘despite being women’.

Konstfack has had financing from KK-stiftelsen (The Knowledge Foundation) for two years to address emerging design challenges in the increasingly complex contexts that design is engaging with. Examples are healthcare, design for sustainable development, social innovation, service design. The objective has been to explore potential expansion and supplementary developments of the currently well-functioning specialisation Individual Study Plan in Design. This has been done in the project Design, beyond service and product – educating for new vistas of design professions. People from academia, consultancy, business and the public sector have been invited to workshops, seminars and symposia in order to learn from them regarding the current situation and anticipated needs. The project has also done study visits to design schools, organisations and businesses. The report presents reflections on design competencies and a few possible ways to proceed at Konstfack.

This paper investigates post-disaster dynamics at the local level, in particular how local identity and social cohesion are affected after an extreme event. A particular case is investigated: the largest forest fire in modern Swedish history, which took place in 2014. The empirical material consists of interviews with forest professionals and organizations involved with the fire or the postfire work and a postal survey to all people directly affected by the wildfire. The analysis finds that the experience of the wildfire and its social interpretation led to the invention of a particular community identity, one that strengthened the self-understanding of the community. Thus, the post-disaster dynamics are pivotal for what social practices that emerge and what local identities are invented and thus may greatly affect the capacity of a community to handle extreme events.

Background: Recurring pain in the vulvovaginal regional induced by touch or pressure is thought to be the most frequent cause of superficial dyspareunia in premenopausal women. Its prevalence is 7-15% in community samples and has a serious impact on couples sexual function, sexual satisfaction, general psychological well-being and overall quality of life.

The last decade of research suggests that psychological factors, such as fear of pain, catastrophizing, and avoidance behavior may contribute to the maintenance and exacerbation of dyspareunia. Conventional cognitive behavioral therapy (CBT) interventions aim at reducing pain, restoring sexual function and improving the romantic relationship by targeting the thoughts, emotions, behaviors and couple interactions associated with the experience of dyspareunia. Furthermore, given the interpersonal sexual context in which dyspareunia is most often triggered, relationship factors is an important area to address.

Methods: The current study consists of a CBT group treatment program of 10 group sessions and 3 individual couple sessions distributed over a period of 6 months. The study will employ a single case experimental design with multiple baselines (N=6) where each individual represents a case and is randomized to a specific length of baseline. The primary and secondary outcomes will be measured weekly through both baseline and treatment phase to enable investigation of changes in outcome between the two phases. Additionally, secondary outcomes for both women and their partners are measured pre- and post-treatment. Single case experimental designs are recommended as a first step to investigate individual responses to psychological interventions as well as testing interventions as a pilot before implementing treatments in extensive RCT studies (Morley, 2017).

Results: Data collection is in progress and will be completed early June 2018. The results of the study will be presented at the conference.

This study illustrates the sporadic distribution of metals in fluvial systems flowing from catchments to urban settlements. This is a detailed study prognosticating the deteriorating quality of rivers at specific locations due to metal pollution. Heavy metals like cadmium, lead, nickel and mercury are prominent in industrial sector. Contour plots derived using spatial and temporal data could determine the focal point of metal pollution and its gradation. Metal values recorded were cadmium 157 mg/L, lead 47 mg/L, nickel 61 mg/L and mercury 0.56 mg/L. Prokaryote diversity was less in polluted water and it harboured metal tolerant bacteria, which were isolated from these polluted sites. Actinomycetes like Streptomyces and several other bacteria like Stenotrophomonas and Pseudomonas isolated from the polluted river sites exhibited changes in morphology in presence of heavy metals. This stress response offered remedial measures as Streptomyces were effective in biosorption of cadmium, nickel and lead and Stenotrophomonas and Pseudomonas were effective in the bioaccumulation of lead and cadmium. The amount of 89 mg of lead and 106 mg of nickel could be adsorbed on one gram of Streptomyces biomass-based biosorbent. Such biological remedies can be further explored to remove metals from polluted sites and from metal contaminated industrial or waste waters.

Background: Cardiovascular diseases (CVDs) and cancers are the major causes of chronic arsenic exposure-related morbidity and mortality. Matrix metalloproteinase-2 (MMP-2) and −9 (MMP-9) are deeply involved in the pathogenesis of CVDs and cancers. This study has been designed to evaluate the interactions of arsenic exposure with serum MMP-2 and MMP-9 concentrations especially in relation to the circulating biomarkers of CVDs.

Methods: A total of 373 human subjects, 265 from arsenic-endemic and 108 from non-endemic areas in Bangladesh were recruited for this study. Arsenic concentrations in the specimens were measured by inductively coupled plasma mass spectroscopy (ICP-MS) and serum MMPs were quantified by immunoassay kits.

Results: Serum MMP-2 and MMP-9 concentrations in arsenic-endemic population were significantly (p < 0.001) higher than those in non-endemic population. Both MMPs showed significant positive interactions with drinking water (rs = 0.208, p < 0.001 for MMP-2; rs = 0.163, p <0.01 for MMP-9), hair (rs= 0.163, p < 0.01 for MMP-2; rs = 0.173, p < 0.01 for MMP-9) and nail (rs= 0.160, p < 0.01 for MMP-2; rs = 0.182, p < 0.001 for MMP-9) arsenic of the study subjects. MMP-2 concentrations were 1.02, 1.03 and 1.05 times, and MMP-9 concentrations were 1.03, 1.06 and 1.07 times greater for 1 unit increase in log-transformed water, hair and nail arsenic concentrations, respectively, after adjusting for covariates (age, sex, BMI, smoking habit and hypertension). Furthermore, both MMPs were increased dose-dependently when the study subjects were split into three (≤10, 10.1-50 and > 50 μg/L) groups based on the regulatory upper limit of water arsenic concentration set by WHO and Bangladesh Government. MMPs were also found to be significantly (p < 0.05) associated with each other. Finally, the concentrations of both MMPs were correlated with several circulating markers related to CVDs.

Conclusions: This study showed the significant positive associations and dose–response relationships of arsenic exposure with serum MMP-2 and MMP-9 concentrations. This study also showed the interactions of MMP-2 and MMP-9 concentrations with the circulating markers of CVDs suggesting the MMP-2 and MMP-9 -mediated mechanism of arsenic-induced CVDs.

Here, we report the genomic sequence and genetic composition of an arsenic resistant bacterium Lysinibacillus sphaericus B1-CDA. Assembly of the sequencing reads revealed that the genome size is ~4.5 Mb encompassing ~80% of the chromosomal DNA.

Previously, we reported a chromium-resistant bacterium, Enterobacter cloacae B2-DHA, isolated from the landfills of tannery industries in Bangladesh. Here, we investigated its genetic composition using massively parallel sequencing and comparative analysis with other known Enterobacter genomes. Assembly of the sequencing reads revealed a genome of ~4.21 Mb in size.

Background: Arsenic is a potent pollutant that has caused an environmental catastrophe in certain parts of the world including Bangladesh where millions of people are presently at risk due to drinking water contaminated by arsenic. Chronic arsenic exposure has been scientifically shown as a cause for liver damage, cancers, neurological disorders and several other ailments. The relationship between plasma cholinesterase (PChE) activity and arsenic exposure has not yet been clearly documented. However, decreased PChE activity has been found in patients suffering liver dysfunction, heart attack, cancer metastasis and neurotoxicity. Therefore, in this study, we evaluated the PChE activity in individuals exposed to arsenic via drinking water in Bangladesh.

Methods: A total of 141 Bangladeshi residents living in arsenic endemic areas with the mean arsenic exposure of 14.10 ± 3.27 years were selected as study subjects and split into tertile groups based on three water arsenic concentrations: low (< 129 μg/L), medium (130-264 μg/L) and high (> 265 μg/L). Study subjects were further sub-divided into two groups (≤50 μg/L and > 50 μg/L) based on the recommended upper limit of water arsenic concentration (50 μg/L) in Bangladesh. Blood samples were collected from the study subjects by venipuncture and arsenic concentrations in drinking water, hair and nail samples were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). PChE activity was assayed by spectrophotometer.

Results: Arsenic concentrations in hair and nails were positively correlated with the arsenic levels in drinking water. Significant decreases in PChE activity were observed with increasing concentrations of arsenic in water, hair and nails. The average levels of PChE activity in low, medium and high arsenic exposure groups were also significantly different between each group. Lower levels of PChE activity were also observed in the > 50 μg/L group compared to the ≤50 μg/L group. Moreover, PChE activity was significantly decreased in the skin (+) symptoms group compared to those without (-).

Conclusions: We found a significant inverse relationship between arsenic exposure and PChE activity in a human population in Bangladesh. This research demonstrates a novel exposure-response relationship between arsenic and PChE activity which may explain one of the biological mechanisms through which arsenic exerts its neuro-and hepatotoxicity in humans.

The previously described chromium resistant bacterium, Enterobacter cloacae B2-DHA, was isolated from leather manufacturing tannery landfill in Bangladesh. Here we report the entire genome sequence of this bacterium containing chromium and other heavy metal resistance genes. The genome size and the number of genes, determined by massive parallel sequencing and comparative analysis with other known Enterobacter genomes, are predicted to be 4.22 Mb and 3958, respectively. Nearly 160 of these genes were found to be involved in binding, transport, and catabolism of ions as well as efflux of inorganic and organic compounds. Specifically, the presence of two chromium resistance genes, chrR and chrA was verified by polymerase chain reaction. The outcome of this research highlights the significance of this bacterium in bioremediation of chromium and other toxic metals from the contaminated sources.

There is an increasing need to derive semantics from real-world observations to facilitate natural information sharing between machine and human. Conceptual spaces theory is a possible approach and has been proposed as mid-level representation between symbolic and sub-symbolic representations, whereby concepts are represented in a geometrical space that is characterised by a number of quality dimensions. Currently, much of the work has demonstrated how conceptual spaces are created in a knowledge-driven manner, relying on prior knowledge to form concepts and identify quality dimensions. This paper presents a method to create semantic representations using data-driven conceptual spaces which are then used to derive linguistic descriptions of numerical data. Our contribution is a principled approach to automatically construct a conceptual space from a set of known observations wherein the quality dimensions and domains are not known a priori. This novelty of the approach is the ability to select and group semantic features to discriminate between concepts in a data-driven manner while preserving the semantic interpretation that is needed to infer linguistic descriptions for interaction with humans. Two data sets representing leaf images and time series signals are used to evaluate the method. An empirical evaluation for each case study assesses how well linguistic descriptions generated from the conceptual spaces identify unknown observations. Furthermore, comparisons are made with descriptions derived on alternative approaches for generating semantic models.

This essay calls for an independent theory of features in object-oriented philosophy. Theories offeatures are in general motivated by at least two interconnected demands: 1) to explain why objects have thecharacteristics they have, 2) to explain how regular divisions in those characteristics can be intuited. Whilea theory of universal properties may be the most internally consistent means of addressing these demands,an object-oriented metaphysics needs to address them without a concept of shared features. This meansthat regular divisions of invariant features and our intuitions of them cannot be explained by the repetitionof self-same characteristics or natural laws. They can instead be explained by the immanent repetition ofsimilar features. However, this requires a new, radically aesthetic understanding of what it means to besimilar in the first place, one in which similarity is an emergent process rather than a state of affairs existingbetween resembling particulars.

This article focuses on assessment processes in the school subject of physical education (PE). Inspired by Torrance, the overarching research question is: ‘What might assessment involve if it focuses on the development and identification of collective understanding, collaboratively produced through educational experiences?’ The purpose of the study is to illustrate what characterises transformative assessment and show how it can be addressed in PE practice. A combination of group interviews with teachers, lesson observations and individual interviews with students and teachers was used to gather the empirical material. The analysis was based on three aspects of transformative assessment: responsibilisation; subjectification; and collaboration. Three empirical illustrations show what transformative assessment might involve in relation to learning tasks such as: the training log; the group choreography; and the case of exercise physiology. The views presented in this article contribute to the knowledge about the field in the following ways. First, the illustrations show that the ‘whats’, ‘hows’, ‘whoms’ and ‘whys’ in the assessment practice are often negotiable, which prevents a simplified understanding of the four aspects of assessment literacy: comprehension; application; interpretation; and critical engagement. Second, the notion of transformative assessment could hinder a reductive use of assessment for learning and promote collaborative learning and social justice in today’s heterogeneous PE practices.

Improvisation in general music education is still a somewhat underdeveloped practice. Moreover, attempts to justify its place in the curriculum have often focused solely on its (measurable) outcomes. In this article, we claim that a deeper understanding of students' meaning-making processes in experiences of improvisation is necessary in order to develop improvisation practice and research. The purpose of this article is to offer a music education perspective on improvisation based on John Dewey's transactional perspective on aesthetic experience and meaning-making. Related to this, we suggest and illustrate a Practical Epistemology Analysis (PEA) as a way of analysing meaning-making in music improvisation within general music education. The method of analysis is illustrated by vignettes from video analyses of music lessons in two Swedish schools with pupils aged 9-10 and their free improvisations. The vignettes show how PEA enables analyses of situated meaning-making in the progress of the pupils' improvisation activities. Further, the transactional perspective makes educational values of improvisation visible, such as musical and personal agency, and elucidates cognitive, embodied and ethical aspects of musical meaning-making.

This paper discusses recent parenting policies – parental leave and formal childcare policies – in Sweden and Germany. It argues that parenting policies can support paternal involvement, gender equality and caring masculinities, although with some limitations. The paper recommends an increased focus of men as fathers, children's needs, and time in parenting policies.

We derive two covariance structures under two different invariance restrictions. The obtained covariance structures reflect both circularity and exchangeability present in the data. In particular, estimation in the balanced random effects with block circular covariance matrices is considered. The spectral properties of such patterned covariance matrices are provided. Maximum likelihood estimation is performed through the spectral decomposition of the patterned covariance matrices. Existence of the explicit maximum likelihood estimators is discussed and sufficient conditions for obtaining explicit and unique estimators for the variance-covariance components are derived. Different restricted models are discussed and the corresponding maximum likelihood estimators are presented.

This thesis also deals with hypothesis testing of block covariance structures, especially block circular Toeplitz covariance matrices. We consider both so-called external tests and internal tests. In the external tests, various hypotheses about testing block covariance structures, as well as mean structures, are considered, and the internal tests are concerned with testing specific covariance parameters given the block circular Toeplitz structure. Likelihood ratio tests are constructed, and the null distributions of the corresponding test statistics are derived.

The use of commodity polymers such as polypropylene (PP) is key to open new market segments and applications for the additive manufacturing industry. Technologies such as powder-bed fusion (PBF) can process PP powder; however, much is still to learn concerning process parameters for reliable manufacturing. This study focusses in the process–property relationships of PP using laser-based PBF. The research presents an overview of the intrinsic and the extrinsic characteristic of a commercial PP powder as well as fabrication of tensile specimens with varying process parameters to characterize tensile, elongation at break, and porosity properties. The impact of key process parameters, such as power and scanning speed, are systematically modified in a controlled design of experiment. The results were compared to the existing body of knowledge; the outcome is to present a process window and optimal process parameters for industrial use of PP. The computer tomography data revealed a highly porous structure inside specimens ranging between 8.46% and 10.08%, with porosity concentrated in the interlayer planes in the build direction. The results of the design of experiment for this commercial material show a narrow window of 0.122 > Ev > 0.138 J/mm3 led to increased mechanical properties while maintaining geometrical stability.

Models that describe symmetries present in the error structure of observations have been widely used in dierent applications, with early examples from psychometric and medical research. The aim of this article is to study a multilevel model with a covariance structure that is block circular symmetric. Useful results are obtained for the spectra of these structured matrices.

In this article we consider a multilevel model with block circular symmetric covariance structure. Maximum likelihood estimation of the parameters of this model is discussed. We show that explicit maximum likelihood estimators of variance components exist under certain restrictions on the parameter space.

This thesis presents the contribution to research that my doctoral education led to. My starting point was a large scale qualitative research project (here after called the VR-project) which reviewed the implementation of national tests in the third grade on the subject of mathematics. The VR-project investigated how the test affected the pupils with a special focus on pupils in need of special support. An urge to look further into issues concerning the support, the pupil in need and the test was revealed in he initial VR-project. These issues therefore constitutes the problem area of this thesis. The VR-project studied a total of 22 classrooms in two different municipalities' during 2010- 2012. The methodology used for this project was inspired by ethnography and discourse analysis. The raw data consisted of test instructions, video observations of the actual test subjects, interviews from teachers and pupils about the test, the support that was given throughout the testing as well as the observations and interviews of the pupils requiring special assistance. Activated discourses and positions of the participants were demarcated. The results revealed that a traditional testing discourse, a caring discourse and a competitive discourse are activated during the tests. The testing discourse is stable and traditional. Much of what was shown and said in classrooms, routines and rules regarding the test were repeated in all the schools and in all the classrooms. The discourse on support is affected by ambiguity, which is revealed especially when issues of pupils’ equity is put against the tests equality. This is connected to the teachers restricted agency to give support due to the teacher position as a test taker. The positions in need that are available to students are not the same in pupils, teachers and steering documents. The situation is especially troublesome for pupils that do not manage Swedish good enough to take the test and for pupils in need of special support. Some of the conclusions from this thesis is that the national test format: Disciplines not only the pupil, but also the teacher, the classroom and the school at large. Results indicate that the test:

Activates a focus on achievementLeads attention away from learning Activates issues of accountability Influences pupils and teachers with stakes involved

Besides evaluating knowledge, the test disciplines not only the pupil, but also the teacher, the classroom and the school at large. Discussing the national test as an arena for equity might be a way towards attaining equality in education for all pupils.

Multilingual students’ participation in national tests in mathematics – discursive prerequisites. This article explores discursive prerequisites in test-taking for second language learners with other mother tongues than Swedish. Four students were interviewed in 2016 during their final year of compulsory school. The results imply that multilingual students are positioned as disadvantaged within testing. This phenomenon is mainly situated in a competitive discourse with several subordinated discourses that further position the students: A discourse of justice positioned the students as being sorted or left behind, a discourse of handling the assessment positioned the students as caretakers and a discourse of future challenges positioned the students as struggling while learning, being capable to learn or facing positive challenges. The results imply that national testing is a personal and relational experience and gives rise to issues of legitimacy and equality. These issues should be considered in policy-making, the construction and the carrying out of tests as well as in the conclusions which are based on the results on individual, group and organisational levels.

This article sheds light on a number of discursive conditions relating to being researchers in mathematics education and with an interest in diversity. The data derived from a self-reflective trialogue (dialogue of three people) between the three authors, three researchers. Two of Foucault’s governing technologies were adopted: technologies of power and technologies of the self. By exploring regularities between these in our trialogue we construed formations of governing technologies in relation to subjectification and subjectivation. We uncovered five formations: “Tensions between mathematics education (ME) researchers from different traditions through processes of normalization and othering”, “Limiting space between ME researchers within the socio- political through dismissal of knowledge”, “The socio-political tradition of a need for theory connects theory and ME researcher's’ self-cultivation”, “The researchers’ processes of self-cultivation connect theory and compassionate research practices”. and “Research on policy statements as resistance towards technologies of domination in society”.

A number of studies from pragmatics and discourse analysis have investigated the function of stance adverbs, such as clearly, fortunately, frankly, perhaps, and technically, when used to qualify utterances. Within the field of argumentation studies, scholars who have paid attention to these words have primarily focused on the so-called modal adverbs, and have not considered the insights that can be gained by treating the class of stance adverbs as the linguistic realisation of a certain move in an argumentative discussion. This study aims to fill this gap by investigating the strategic function of stance adverbs when qualifying an utterance that functions as a standpoint. In this study, stance adverbs are examined as a presentational device at the arguer’s disposal when putting forward a standpoint. The study is comprised of three parts. In the first part, the question ‘What is a qualified standpoint?’ is answered by combining illocutionary analysis of the move of advancing a standpoint with pragma-linguistic study of stance ad­verbs. In the second part, the question ‘Why would the protagonist qualify the standpoint?’ is answered based on the concept of burden of proof, which is es­sential to the move of advancing a standpoint. In the third part, the question ‘How does standpoint qualification function strategically in an argumentative discussion?’ is answered by postulating that the protagonist of a qualified standpoint is interested in managing the burden of proof, an assumption which builds on the results of the other two parts. The book is of interest to advanced students and scholars of argumentation and communication studies as well as those interested in an explanation of language use from an argumentative perspective.

The distinction between explicatures and implicatures as well as their varying degrees of strength acknowledged within Relevance Theory can help to capture the complex meaningmaking processes underlying the interpretation of multimoda ltexts as instances of argumentation. These pragmatic insights will be used to compare the ways in which arguments about the revolutionary character and societal impact of nanotechnology are constructed by computer-generated images of the nanoscale on the covers of scientific journals and science magazines.

E‑government is currently high on the agenda in many developing countries (DCs). While e‑government is well‑established in many developed countries it is new to least developed countries. Countries that start implementing e‑government today can benefit from easy import of modern technologies, but adaptation to local conditions and the organizational change that is required cannot be imported, but must be developed at home. By using examples of an ongoing initiative by the Government of Rwanda to digitalize all G2C and G2B into a single window platform, the current study investigated the important challenges in the implementation of e‑government in Rwanda. An interpretive case study was followed. Data was collected through interviews and participatory observations during August to December 2015. Data analysis was inductive, the analysis method was content analysis, and the coding followed open‑coding. NVivo software has been used to handle data and facilitate the analysis. The study found six overarching categories of aspects that challenge a successful implementation of e‑government in Rwanda. They include information infrastructure for e‑government, social inclusion, governance, management, trust in the new system, and languages. However, challenges to e‑government implementation should not be taken as of the same extent, neither their degree of mitigation. Rather, they influence and are influenced by various contextual factors which include political support, nature of the e‑government project, implementation strategies, human and socio‑economic development, existing information infrastructure, and operational capabilities. Having said this, we also argue that countries should learn from one another of their experiences, success stories, and mistakes. Despite a number of associated challenges, the adopted public‑private partnership (PPP) approach to e‑Government implementation in Rwanda might indeed seem as a suitable catalyst for e‑government success in the country.

This thesis takes its point of departure in the research field of intergenerational touch in Physical Education (PE). Previous research in the field have mainly been conducted from a teacher’s perspective and has shown that teachers of PE have become more cautious about using physical contact in recent years. The reasons for this more cautious attitude concerning physical contact is above all, the risk f being falsely suspected of sexual harassment. Previous research has, in a general way, also shown that physical contact in PE is a gendered issue with heteronormative points of departure The overall aim of this thesis is to investigate intergenerational touch in PE from a student perspective. More specifically the aims are to investigate physical contact between teachers and students in PE from a student perspective (paper I), and to investigate which discursive resources students draw on to conceptualize physical contact between teacher and student in PE in relation to heteronormativity (paper II). Six focus group interviews using photo elicitation have been conducted with students at an upper secondary school in Sweden. In paper I it is the concept of the didactic contract that is the theoretical starting point. The results show that, generally, the students support physical contact as a pedagogical tool if the physical contact has a good purpose according to the students. An implicit didactic contract is formed when student and teacher agree on when, how or why physical contact is used as a pedagogical tool. In paper II, the theoretical inspiration comes from Foucault and his work with discourses. The results show that the students’ talk is colored by the heteronormative discourse in society. This is especially expressed when young female students talk about male PE teachers. Heteronormativity is taken for granted and is not really challenged. Students generally support physical contact as a pedagogical tool in PE, however it is a very complex issue and puts high demands on PE teachers’ professionalism.

Öhman, Marie

Abstract [en]

A growing anxiety around intergenerational touch in educational settings has both emerged and increased in recent years. Previous research reveals that Physical Education (PE) teachers have become more cautious in their approaches to students and they avoid physical contact or other behaviour that could be regarded as suspicious (Fletcher, 2013; Öhman, 2016; Piper, Garratt, & Taylor, 2013). Some also feel anxious about how physical contact might be perceived by the students. The purpose of this article is to investigate physical contact between teachers and students in PE from a student perspective. This is understood through the didactic contract. For this purpose, focus group interviews using photo elicitation have been conducted with upper secondary school students in Sweden. One of the major findings is that intergenerational touch is purpose bound, that is, physical contact is considered relevant if the teacher has a good intention with using physical contact. The main agreements regarding physical contact as purpose bound are the practical learning and emotional aspects, such as learning new techniques, preventing injury, closeness and encouragement. The didactic contract is in these aspects stable and obvious. The main disagreements are when teachers interferewhen the students want to feel capable orwhen teachers interfere when physical contact is not required in the activity. In these aspects the didactic contract is easily breached. It is also evident that personal preference has an impact on how physical contact is perceived. In conclusion, we can say that physical contact in PE is not a question of appropriate or inappropriate touch in general, but rather an agreement between the people involved about what is expected. Consequently, we should not ban intergenerational touch, but rather focus on teachers’ abilities to deal professionally with the didactic contract regarding physical contact.

This chapter explores the consequences of pathogenic notions of health in terms of a focus on risk and disease. A salutogenic perspective is an alternative way of discussing young people, social media, and health. In a salutogenic perspective, health resources are the main focus. A salutogenic perspective can help to identify new and diverse resources that young people draw upon to support their health development, such as social relations and/or critical awareness. As a consequence, this chapter highlights the pedagogical potential of social media and how it can educate about health as part of living a good life.

In this paper, we explore the argumentative role of visual metaphor and visual antithesis in theso- fly-on-the-wall documentary. In this subtype of documentary, which emphatically renouncesvoice-over narration, the filmmakers guide their viewers into reaching certain conclusions by makingchoices regarding the editing as well as the cinematography. We analyse a number of scenes from two filmsby one major representative of the Direct Cinema or fly-on-the-wall documentary, Frederick Wiseman.

Argumentative functions of visuals: beyond claiming and justifying2013In: Virtues of argumentation: proceedings of the 10th International Conference of the Ontario Society for the Study of Argumentation (OSSA), 22-26 May 2013 Windsor, ON / [ed] Dima Mohammed; Marcin Lewinski, Ontario Society for the study of Argumentation (OSSA) , 2013, p. 1-17Conference paper (Other academic)

Abstract [en]

Up until now, the study of the argumentative role of visuals has been restricted to theformal concept of argument as product, consisting of premises and conclusion. In this paper, I adoptthe pragma-dialectical approach to argumentation as a social and discursive activity in order toexplore argumentative functions of visuals that go beyond claiming and justifying. To do this I payattention to the visual form and to the interaction between the verbal and the visual mode inargumentative discourse.

Up until now, most studies that deal with the linguistic realization of argumentationare mainly interested in the « indicative potential » of the words and phrases studiedand tend to neglect the potential strategic effect of these words in argumentativediscourse. In this article, I propose a systematic study of “illocutionary adverbs”,such as franchement and honnêtement, when they appear in the utterance thatfunctions as a standpoint. I also argue that the adverbial phrase en fait has the samestrategic effect. In order to account for the strategic role of these adverbs when theyserve as qualifiers of a standpoint, I have recourse to the concept of burden of proof,a concept that is essential to the act of advancing a standpoint. I argue that theseadverbs can be considered as a means at the arguer’s disposal when formulating hisstandpoint to manage the burden of proof to his advantage. As a result, the analystmay consider their presence in the utterance that functions as a standpoint as amarker of the strategy of managing the burden of proof.

Multimodal argumentation: Building bridges between argumentation theory and multimodal analysis

Since the end of the 90s there has been an increasing interest in the analysis of images and in their interplay with written language. Even though images, especially when used in advertisements, have already been studied within rhetorical approaches to communication and visual studies, there still lacks a systematic account of their contribution to the way standpoints are put forward and argumentation is advanced. At the same time, within the field of discourse analysis interest has been expressed in the analysis of visual and other non-verbal elements of communication. Nevertheless, no special attention has been paid within this field to those communicative situations where the support of a standpoint with arguments and the acceptability of the argumentation are at stake. In order to be able to analyse the various aspects of multimodal documents on their merits and to account for their argumentative relevance it is necessary to build bridges between argumentation theory and multimodal analysis. This paper discusses critically the current state of affairs regarding the analysis of multimodal documents from an argumentation studies perspective and argues for a systematic study of the interplay of the verbal and the visual modes within the framework of Pragma-dialectics. Three print advertisements are analysed in order to illustrate the merits of such an approach to the argumentative analysis of multimodal documents.

This paper seeks to specify the strategic function of adverbs like in fact and frankly when used to qualify the utterance that functions as a standpoint in an argumentative discussion. The aim is to provide a description of their strategic function that takes into consideration the role that the move of advancing a standpoint plays in argumentative discourse. To this direction, the choice of qualifying is explained as a choice that the arguer makes in his attempt to manage the burden of proof that is incurred when advancing a standpoint. By combining the insights from the pragma-linguistic treatment of these adverbs with the theoretical premises of a systematic approach to the analysis of argumentative discourse it becomes possible to specify their strategic function and to evaluate those cases in which this strategic function has been abused to the detriment of the quality of argumentative discourse.

What characterizes the regulocrats within the higher education sector in Norway andSweden? How can the regulocrats’ role be related to the development of specific instituti-onal designs within the higher education sector? These questions are answered by meansof empirical studies of regulocrats in Norway and Sweden, within the field of higher edu-cation regulation. The regulocrats are an emerging profession working in autonomoussingle purpose regulatory agencies. The profession is increasingly important to the imp-lementation of policy and regulation. There is surprisingly little empirical evidence aboutthis professional role, and the article shows that the professionalization of the regulocratsis related to the ideal of independence. The emerging profession contributes to the insti-tutional design of regulocracy or regulatory capitalism, which implies a transformation ofthe classical bureaucracy in the modern administrative state, where all (both organizations,groups and individuals) are expected to invest more in regulation, understood as monito-ring, supervision, transparency and control. Within the higher education sector, regulati-ons are perceived as important because they benefit (the individual) students and creategood conditions for making rational choices in the education market. Although the regu-locrats in Norway and Sweden share much of the same professional ideals, there are alsodifferences between the two countries. Where the Swedish regulocrats are formalistic, theNorwegian counterpart is sensitive.

Background: As part of the annual activities at the British Educational Research Association (BERA) conference, the Physical Education and Sport Pedagogy Special Interest Group (SIG) organises a so-called Invisible College, where a Scholar Lecture is delivered by a researcher who has made a significant contribution to the field. This paper is the 2018 Scholar Lecture.

Purpose: The purpose of the paper is to discuss two concepts and the relations between them – health and learning.

Key concepts: In the paper, the metaphor of the swimmer in the river, as introduced by Antonovsky, is used in order to go beyond individualistic, dualistic and instrumental notions of health and education. I argue for a move away from a notion of teaching young people how to be healthy through the deployment of ready-made educational packages, towards acknowledging health education as a societal responsibility, where it is recognised that sociocultural and economic contexts afford diverse opportunities to be healthy and to learn to live healthy lives, however these are construed.

Discussion and conclusion: Rather than confining health and health education to the prevention of premature death and disease, I discuss health, in relation to learning, as always being in the process of becoming. The health resources for living a good life can then be found in the ‘river’, with the ‘swimmer’, and in the relation between the ‘river’ and the ‘swimmer’. In this way, health can manifest itself in many different ways. I ask why we even attempt to talk about health in the singular when talking about different diseases. Is health rather a plural? Is it even a noun? Or is it something we do – a verb? If the latter, health education can be conceived of as a practice – ‘healthying’ – rather than a fixed, static outcome set up by research and public health policies as something to achieve in education.

Of all the human sciences, linguistics has had perhaps the most success in pivoting itself towards the physical sciences, particularly in the past fifty years with the dominance of Universal Grammar, which is most closely associated with the work of Noam Chomsky. One of the most important implications of Universal Grammar has been that language production in its most natural and optimal state is organized analytically, and thus shares the same organizational logic of other knowledge systems in Western science, such as the binomial taxonomization of nature and analytic geometry. This essay argues that recent challenges to Universal Grammar represent more than just a theoretical dispute within a single discipline; they threaten to undermine the hegemony of analytical knowledge systems in general. While analytical logic has served Western science well, analogical knowledge systems may be able to address problems that analytical logic cannot, such as ecological crises, the limitations of artificial intelligence, and the problems of complex systems. Instead of studying languages as a means of modeling human thought in general, languages should also be studied and preserved as heteronomous knowledge systems which themselves exist as embodied objects within particular ecologies. Rethinking language as existing on a univocal plane with other ecological objects will provide us with new insight on the ethics and epistemology of analogical knowledge production.

Similarity has long been excluded from reality in both the analytical and continental traditions. Because it exists in the aesthetic realm, and because aesthetics is thought to be divorced from objective reality, similarity has been confined to the prison of the subject. In The Being of Analogy, Noah Roderick unleashes similarity onto the world of objects. Inspired by object-oriented theories of causality, Roderick argues that similarity is ever present at the birth of new objects. This includes the emergent similarity of new mental objects, such as categories—a phenomenon we recognize as analogy. Analogy, Roderick contends, is at the very heart of cognition and communication, and it is through analogy that we can begin dismantling the impossible wall between knowing and being.

Despite an extensive debate and an openness of teachers to a strength-based approach to health and physical education, it is not always clear what a salutogenic strengths-based approach might look like in practice, at least not in the day-to-day work in schools. The purpose of this article is to present a salutogenic strengths-based school initiative in Sweden and to identify health discourses in the school's practice. An insider perspective is used to explore health in the school through Brookfield's four lenses for exploring one's own teaching practice. Two health discourses are identified: (1) an individual health discourse rooted in the fostering of personal development, and (2) a value-based health discourse build up around social relations and the fostering of democratic values. The individual health discourse can be understood as based in a pathogenic norm, and in the investigated school practice the individual health discourse dominated the school health initiative despite the salutogenic intentions.